The Effect of Amnion Cell Culture Medium on Wound Healing: An Experimental Animal Study.

BACKGROUND/OBJECTIVE: Fetal wound repair seems a relatively efficient process when compared to wound repair during adulthood, which may be explained by the effects of the fetal environment. This study examined the effects of an amnion cell culture medium (ACCM) on skin wound healing in a rat experimental model. METHODS: Sixteen adult female Wistar albino rats were used in this experimental animal study (treatment group, n = 8; control group, n = 8). Surgical wounds were formed on the dorsal skin of each rat. A commercially available ACCM was administered daily over each of the wound in the treatment group for 14 days and the control group did not receive any treatment. Wounds were evaluated for tissue perfusion with laser doppler, tissue superoxide dismutase (SOD), glutathione peroxidase (GPX), and malondialdehyde (MDA) levels as well as histopathological examination. RESULTS: Controls had significantly higher tissue SOD levels when compared to the treatment group (10.0 ± 3.2 vs 6.7 ± 1.2, P = .005); however, the 2 groups did not differ in terms of tissue GPX and MDA levels. For open wounds, inflammation and neovascularization were more prominent in the ACCM group at day 14. However, at day 21 neovascularization and granulation were more prominent in controls. For closed wounds, neovascularization was more prominent in controls at days 14 and 21. The 2 groups did not differ in terms of tissue perfusion. CONCLUSION: Although marginal difference was found between controls and ACCM group for several parameters, findings of this study do not support beneficial effect of ACCM on wound healing.

Autologous omentum transposition for regeneration of a renal injury model in rats.

BACKGROUND: After renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. This study aimed to evaluate the effect of autologous omentum flaps on injured renal tissues in a rat model. METHODS: A total of 30 Wistar albino rats were included and randomly divided equally into a control group and four intervention groups. Iatrogenic renal injuries were repaired using a surgical technique (primary repair 1 group and primary repair 2 group) or transposition of the autologous omentum (omentum repair 1 group and omentum repair 2 group). Blood samples were taken preoperatively and on the 1st and 7th postoperative days in all groups and on the 18th postoperative day in the control and two intervention groups. All rats were sacrificed on the 7th or 18th day postoperatively, and their right kidneys were taken for histopathological evaluation. RESULTS: The mean urea level significantly decreased from day 1 to day 7 and from day 1 to day 18 in the omentum repair 2 group (P = 0.005 and P = 0.004, respectively). There were no other significant changes in urea or creatinine levels within the intervention groups (P > 0.05). There was no significant correlation between the urea and creatinine levels and the histological scores (P > 0.05). The primary repair 1 and 2 groups had significantly higher median granulation and inflammation scores in the kidney specimen than the control and omentum repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). The completion score for the healing process in the kidney specimen was significantly higher in the omentum repair groups than in the primary repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). Granulation degree in the kidney specimen was strongly and positively correlated with the inflammation degree (r = 0.824, P < 0.001) and foreign body reaction in the kidney specimen (r = 0.872, P < 0.001) and a strong and negative correlation with the healing process completion score in the kidney (r = - 0.627, P = 0.001). Inflammation degree in the kidney specimen was strongly and positively correlated with the foreign body reaction in the kidney specimen (r = 0.731, P = 0.001) and strongly and negatively correlated with the healing process completion score in the kidney specimen (r = - 0.608, P = 0.002). CONCLUSION: Autologous omentum tissue for kidney injury repair attenuated inflammation and granulation. Additionally, the use of omental tissue to facilitate healing of kidney injury may theoretically lead to a more effective healing process and reduced fibrosis and tissue and function loss.

Delayed diagnosis and successful management of completely transected common hepatic duct in a blunt multitrauma patient.

Extrahepatic bile duct injuries are very uncommon and easily be missed in multitrauma patients. Patients suffer from bile duct injuries need special approach to this situation. In this report, a case with total transection of common hepatic duct and treatment approach was presented. In unstable patients, damage control surgery can be applied. A 32-year-old male patient was brought to the emergency department after a beating that includes multiple blunt trauma. Radiological screening showed cranial, nasal, lumbar vertebral, and costal bone fractures, decreased blood flow to the right kidney and free perihepatic and perisplenic fluid. Neurosurgeons operated this patient at the day of admission and no plan for laparotomy was made for this patient at that time. Second day postoperatively patient was transferred to the department of surgery and exploratory laparotomy has been made. Common hepatic duct was fully transected and because of the patient's hemodynamic instability, an external fistula has been made. The patient discharged 10th day postoperatively. The patient was operated after follow-up and a Roux-en-y hepaticojejunostomy has been made. Extrahepatic bile duct injuries are rare and high suspicion is important in complex multitrauma patients. Extent of the injury is unique for every patient and technical aspect of repair can be challenging.

Comparison of the Effect of Local and Systemic Injection of Resveratrol on Cutaneous Wound Healing in Rats.

Purpose. To compare the effect of local and systemic injection of resveratrol (RSV) on open cutaneous wound healing. Materials and Methods. Open cutaneous wounds were created in adult Sprague-Dawley rats. Group 1 (n = 6) was given intraperitoneal RSV (0.5 mg/kg) once daily for 14 days. Group 2 (n = 6) was given local subcutaneous RSV (0.5 mg/kg) on the wound once daily for 14 days. Group 3 (n = 6) did not receive any pharmacologic agent. Biopsy specimens were obtained on postoperative days (PODs) 7, 14, and 21 and were examined histologically. Wound closure time was recorded. All rats were sacrificed on POD 30 for tensile strength analysis. Results. The histological scores for collagen deposition, chronic inflammation, and granulation were higher in the systemic and local RSV treatment groups than in the control group. Neovascularization scores significantly increased on PODs 14 and 21 in the local RSV treatment group compared with those in the systemic RSV and control groups. Systemic and local RSV administrations significantly enhanced wound healing and increased the tensile strength of the skin in rats. Conclusion. Local subcutaneous application of RSV may have a better therapeutic effect than the systemic application of RSV in terms of neovascularization to promote wound healing.

Effects of pneumoperitoneum with carbon dioxide on renal and hepatic functions in rats.

INTRODUCTION: Laparoscopic surgery is a preferred method based on its many benefits. However, increasing abdominal pressure by CO2 insufflation during the implementation of this technique poses challenges. AIM: To determine the degree of renal and liver injury that occurs in a pneumoperitoneum (PP) model of prolonged CO2 insufflation. MATERIAL AND METHODS: Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and given anesthesia for 3 h. In group 2, PP was administered under anesthesia for 1 h. In the last group, PP was administered under anesthesia to animals for 3 h. We measured renal and liver injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers including kidney injury molecule-1 (KIM-1) with histopathological findings. RESULTS: Histopathological analysis according to the kidney ischemia tubular damage score showed a statistically significant difference between the 3 groups (p < 0.001). There was an increase in KIM-1 levels in the groups, although it was not statistically significant (p = 0.062, p = 0.156, p = 0.350 respectively). According to the correlation test in this research, KIM-1 results had a statistically significant association with creatinine, urea, aspartate aminotransferase and alanine aminotransferase levels in all control and study groups. CONCLUSIONS: According to our results, the increase in KIM-1 was correlated with Cr levels and compatible with histopathological analysis. Moreover, intra-abdominal pressure statistically significantly increased the degree of kidney injury and there was not a significant increase in the levels of KIM-1. There was no difference in liver damage between groups.

The Effect of Prognostic Factors on Long-Term Protection in Breast Cancer.

Objectives Axillary lymph node involvement is considered to be one of the most important factors in the staging and survival of breast cancer. Recurrences in women with a negative axillary condition detected as a result of long patient follow-up have revealed the importance of other prognostic factors and many studies have begun. The aim of this study is to evaluate breast cancer patients and to investigate other factors affecting breast cancer. Materials and methods Patients with breast cancer who were operated in our clinic between January 2005 and June 2007 were included in the study. Demographic characteristics, tumor size, lymph node involvement, grade, histological type, the status of estrogen and progesterone receptors (ER and PR), type of surgery performed, and cerb-B2 receptor status were recorded retrospectively. Results The mortality rate of the ER (+) PR (+) group was significantly lower than that of the ER (-) PR (-) group (p<0.05). There was no statistically significant difference between the ER (+) PR (+) cases and the mortality rates of any positive cases (p>0.05). There was a statistically significant difference between survival rates according to cerb-B2 status (p<0.01); cerb-B2 was positive in all patients who died. In cerb-B2 positive cases, there was a statistically significant difference between survival rates according to the tumor stages (p <0.05). Conclusion As a result; preoperative and postoperative staging of all breast cancer patients who applied to surgery clinics should be performed. Prognostic factors should be determined and patients should be directed to post-surgical treatment according to this information. Axillary lymph involvement, number, tumor size, estrogen receptor, progesterone receptor, and cerb-B2 status are safe markers that can be used to determine prognosis in our series.

Evaluation of the Effects of Preoperative Dexamethasone Administration on Postoperative Patient Comfort in Laparoscopic Cholecystectomy.

Objective Postoperative recovery process following laparoscopic cholecystectomy depends on many factors such as pain, fatigue and exhaustion. The objective of this study was to investigate whether the administration of dexamethasone, a glucocorticoid, has positive effects of postoperative patient comfort in patients who underwent laparoscopic cholecystectomy in our clinic. Methods Patients who presented to the general surgery clinic of our hospital and scheduled for laparoscopic cholecystectomy due to cholelithiasis were included in this study. Patients in Group 1 received dexamethasone 90 minutes before the skin incision, while patients in Group 2 were given placebo (normal saline). Pain scores, presence of nausea and vomiting in the postoperative period were compared between the study and control groups. Results No statistically significant difference was observed between the groups in terms of incisional pain at rest and in motion and visceral pain at rest at postoperative 6th, 12th and 24th hours. Although there was a difference between the groups in terms of visceral pain in motion at the postoperative 12th and 24th hours, this was not statistically significant (p > 0.05). Although the need for additional analgesics and antiemetic drugs was lower in the study group compared to the control group, the difference between the groups was not statistically significant (p > 0.05). Conclusion We can expect better results with the use of multimodal analgesic and anti-emetic combination instead of a single agent in studies to be performed about the prevention of postoperative pain, nausea and vomiting.

A previously diagnosed mitochondrial neurogastrointestinal encephalomyopathy patient presenting with perforated ileal diverticulitis.

Mitochondrial neurogastrointestinal encephalomyopathy is an autosomal recessive multisystem disorder characterized clinically by severe gastrointestinal dysmotility; cachexia; ptosis, opthalmoparesis or both; peripheral neuropathy; leukoencephalopathy and mitochondrial abnormalities in muscle. Gastrointestinal dysmotility causes intestinal pseudo-obstruction and small intestinal diverticula. In this case report, we present a previously diagnosed 32-year-old female mitochondrial neurogastrointestinal encephalomyopathy syndrome patient who was hospitalized and operated due to ileal diverticulitis perforation and died due to postoperative respiratory complications, and we discuss the characteristic manifestations of the disease.